Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.02 / $12.02 / $12.02	Facility	26	$12.02	$12.02	$12.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $100.00 / $263.03	Professional		$72.44	$100.00	$263.03
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $15.14 / $50.12	Professional	26	$10.96	$15.14	$50.12
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $28.84 / $229.09 / $371.54	Professional	52	$28.84	$229.09	$371.54
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $63.10 / $79.43 / $177.83	Professional	TC	$63.10	$79.43	$177.83
BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $8.51 / $9.77 / $9.77	Facility	26	$8.51	$9.77	$9.77
BCBS Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $199.53 / $295.12	Professional		$120.23	$199.53	$295.12
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $17.38 / $28.84 / $41.69	Professional	26	$17.38	$28.84	$41.69
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $109.65 / $177.83 / $257.04	Professional	TC	$109.65	$177.83	$257.04
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.55 / $36.31 / $100.00	Facility	26	$9.55	$36.31	$100.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $208.93 / $354.81	Professional		$97.72	$208.93	$354.81
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.88 / $28.84 / $47.86	Professional	26	$12.88	$28.84	$47.86
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $85.11 / $181.97 / $309.03	Professional	TC	$85.11	$181.97	$309.03
Health Partners Facility/Professional Facility Modifier 26 Low / Median / High Price $32.36 / $39.81 / $77.62	Facility	26	$32.36	$39.81	$77.62
Health Partners Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $208.93 / $338.84	Professional		$144.54	$208.93	$338.84
Health Partners Facility/Professional Professional Modifier 26 Low / Median / High Price $19.05 / $28.18 / $44.67	Professional	26	$19.05	$28.18	$44.67
Health Partners Facility/Professional Professional Modifier TC Low / Median / High Price $123.03 / $181.97 / $288.40	Professional	TC	$123.03	$181.97	$288.40
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $125.89 / $125.89 / $125.89	Facility	26	$125.89	$125.89	$125.89
Medica Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $169.82 / $776.25	Professional		$87.10	$169.82	$776.25
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $12.88 / $23.44 / $269.15	Professional	26	$12.88	$23.44	$269.15
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $74.13 / $144.54 / $691.83	Professional	TC	$74.13	$144.54	$691.83
United Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $158.49 / $275.42	Professional		$87.10	$158.49	$275.42
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.88 / $21.88 / $39.81	Professional	26	$12.88	$21.88	$39.81
United Facility/Professional Professional Modifier TC Low / Median / High Price $74.13 / $138.04 / $234.42	Professional	TC	$74.13	$138.04	$234.42